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Board Certification for Radiology Coders: Added Value Indeed
Richard Duszak, Jr., M.D.

The Board Certification Quiz.
Ask your radiologists to take this quiz, and then talk with them about the benefits of becoming board certified in your field.

1. Do board-certified doctors perform better?
2. Are board-certified doctors more active in professional organizations?
3. Are board-certified doctors less likely to get sued?
4. Do patients prefer board-certified doctors?

The answer to all of these questions is yes. The reasons that physicians value board certification for themselves are the very same reasons they should support their coders as they seek similar recognition.

Business managers, coders, and billing companies alike need to educate physicians about the process and gain their support. Physicians, after all, usually control the purse strings of their practices. Their support will be critical in assuring that this designation carries with it the distinction it deserves.

The concept of independent verification of competency is not new to the medical profession. For years, physicians have pursued courses of studies and examinations that designate them as board certified. Such designations carry with them a "Good Housekeeping seal of approval" to the lay public and are now available for numerous non-physician medical professionals. The pursuit of such recognition carries with it a price, in terms of commitment, time and money. Examination preparation can be extensive and grueling, and professionals must be willing to take time away from their work and be willing to pay for the examination and travel. These are only minor obstacles for most professionals. Such sacrifices are a small price to pay for independent recognition of their competency. Outlined below are several reasons physicians strive to achieve board certification and why their coders should be supported as they do the same.

Board-certified physicians perform better. The perception that board-certified doctors are better doctors is supported by the literature. Board-certified physicians performed better in medical school and residency than non-certified physicians1, and will likely do so in practice. It seems logical that certified coders will demonstrate better performance as well. No one knows how frequent coding errors occur in diagnostic radiology, but they are probably not uncommon. Coding error rates are potentially as high as 25 percent for both non-radiology procedures2 and interventional radiology services3! Accordingly, practices need to ensure that only the most qualified individuals participate in their coding.

Board-certified physicians are more active in professional organizations. Board-certified physicians are more likely to maintain a professional society membership4, which means that they are more likely to attend meetings and interact with their colleagues nationally. Both increase the likelihood that the physician will remain current in his training and education. Coders who make the commitment to obtain board certification will likely make the same commitment to long-term professional development, a commitment that clearly benefits the radiology practice in the long-term.

Board-certified physicians are less likely to get sued. In the current litigious environment, all professionals risk exposure for their professional work. Although nothing absolutely protects physicians from lawsuits, it has been shown that board-certified physicians are less likely to get sued than non-certified colleagues5. There might be a similar reduction in legal risk when coders obtain board certification. Coding and billing compliance is important to every radiology practice, and having independently certified coders may reduce a practice's coding error rate and reduce the legal exposure a practice might otherwise face in the event of an audit.

Patients prefer board-certified physicians. Patients prefer board-certified doctors6 for a variety of good reasons. Everyone wants the professional they hire (regardless of occupation) to be competent, and board certification goes a long way in ensuring such competency. The same applies for coders: all else being equal, a certified coder is more likely to engender confidence than one who hasn't achieved that distinction.

The commitment to board certification is a serious and important one. It requires hard work, and costs both time and money. That recognition carries with it, however, significant value. Radiology practices everywhere should view the upcoming Radiology Coding Certification Board Examination as an opportunity to improve their coding and billing operations and prove to everyone how good a job they do. Everyone wants their doctor to be board certified. Everyone knows that board certified doctors are better doctors. Shouldn't the same hold true for coders?

References
1. Xu G, Veloski JJ, Hojat M. Board certification: associations with physicians' demographics and performances during medical school and residency. Acad Med 1998; 73: 1283-1289.
2. Kritzler A. New collaborative approach by Minnesota peer review organization reduced CPT coding disagreements. J AHIMA 1997; 68: 52-55.
3. Duszak R, Sacks D, Manowczak J. CPT coding by interventional radiologists: accuracy and implications. In Press.
4. Deitch CH, Chan W, Sunshine JH. Patterns of professional organization membership among radiologists in the United States. Invest Radiol 1994; 29: 381-386.
5. Adamson TE, Baldwin DC, Sheehan TJ, Oppenberg AA. Characteristics of surgeons with high and low malpractice claims rates. West J Med 1997; 166: 37-44.
6. Engstrom S, Madlon-Kay DJ. Choosing a family physician: what do patients want to know? Minn Med 1998; 81: 22-26.

Dr. Richard Duszak previously served as ACR Liaison Director on the Radiology Coding Certification Board. He currently serves on the Executive Committee of the CPT Editorial Panel, chairs the ACR’s Harvey L. Neiman Health Policy Institute, and practices radiology with Mid-South Imaging and Therapeutics in Memphis, TN.